Stress, lifestyle and diabetes: using the allostatic load model to translate research into practice (#109)
The allostatic load model provides a useful narrative for understanding the translation of research into practice. According to the model, stress, both psychosocial (such as relationship and money worries) and physical (such as injuries and illnesses), leads to chronic low-grade inflammation. The inflammatory response includes increased blood pressure, higher levels of blood sugar and fats, and the release of hormones such as cortisol and catecholamines. Stress, perhaps via inflammation, also leads to a shortening of telomeres, which are chromosomal markers of biological age. In the short run, the stress response is helpful, but in the long run it is harmful. Chronic low-grade stress will increase the body’s allostatic load, a basket of risk factors for non-communicable diseases including blood lipids, waist circumference, and blood sugar levels. High allostatic load will eventually translate into overt disease, including diabetes, cardiovascular disease, depression, asthma, and perhaps even osteoporosis and oral disease. Lifestyle behaviours such as physical activity, sedentary behaviours, sleep, diet and social interactions can buffer the effects of stress, and increase individual resilience. Physical activity, 7-8 hours of sleep a night and certain dietary patterns such as the Mediterranean diet dampen the inflammatory response, while excessive sitting, short or long sleep, and diets high in refined foods are pro-inflammatory. There is increasing research evidence for the allostatic load model. It helps to explain a wide range of apparently disparate observations such as the clustering of non-communicable diseases within individuals, the beneficial effects of nutrients such as omega-3 fatty acids, the effectiveness of anti-inflammatories in the treatment of diseases such as depression, and the multiple benefits of physical activity across a wide range of diseases.